Sigmoidoscopy

Overview

Sigmoidoscopy is the procedure in which the doctor examines the rectum and colon using an instrument called a sigmoidoscope. Sigmoid colon is the final part of the intestine, rectum related.

The sigmoidoscope is a small tube, which has one a light source at an end, with a similar thickness of a finger. The specialist will introduce the sigmoidoscope into anus, and slowly pushes it into the rectum to the sigmoid colon.

This way, the doctor can view and analyze the rectum and sigmoid colon mucosa. The procedure is painless, but may involve a little discomfort.

Types of sigmoidoscopy

There are two types of instruments that carry sigmoidoscopy. The most commonly used is flexible sigmoidoscope, which allows the physician to evaluate all curved areas of the colon. Flexible sigmoidoscope provides a better picture of the lower colon and usually is more comfortable examination.

Rigid sigmoidoscope was replaced in most cases with flexible version, being used more rarely. This allows the doctor to view the rectum and the lower colon, but it can’t enter the colon, in the same way as flexible sigmoidoscope.

Alternatives to sigmoidoscopy

Depending on your symptoms and circumstances, in order to establish a good diagnose health problems a person may be required and another investigation. The alternatives include:

- barium enema – this involves drinking a liquid that contains barium (a substance easily seen with X-rays), which will reach the intestine and rectum. With this investigation, both inside of the abdomen and the intestine can be viewed more clearly,. - virtual colonoscopy and CT colonoscopy – involves using abdominal CT scan. CT scanning uses X-rays to produce three-dimensional images of the colon and rectum. - FOB test (for occult bleeding) – is useful for detecting blood in a stool sample. - colonoscopy – is similar to flexible sigmoidoscopy, but can analyze the entire large intestine. - proctoscopy – this is an examination of the anal canal using a tube with a size of about 10 cm long. The technique involves viewing and treating polyps and hemorrhoids.

Probably for a diagnosis, you may need a combination of tests and investigations. Your doctor will present the options.

Preparation for sigmoidoscopy

Sigmoidoscopy is well tolerated by most people. The procedure is usually done in a doctor’s office without the need for sedation or anesthesia. Your doctor may recommend a strong laxative to empty the bowel of feces contents before sigmoidoscopy. There are several medications for bowel cleansing, after which triggers diarrhea, which can be uncomfortable.

If the bowel is not emptied of feces, the test may be limited and may need to be repeated at a later date. With about an hour before the procedure the enema will be done. Diet and bowel enema will clean the intestine and the doctor can carefully analyze colon.

During the procedure

During flexible sigmoidoscopy, the patient will wear only a robe. Analgesics and sedatives are not necessary.

The patient will lie on one side, on an examination table, usually with his knees pointing to the chest. The doctor will insert a sigmoidoscope into rectum. The sigmoidoscope contains a tube with a light source, which will pump air into the colon to the lining of the colon to be better visualized. If the sigmoidoscope is moved or when the air is introduced, the patient may have abdominal cramps or feel the need to defecate.

The sigmoidoscope also contains a video camera at one end, which will provide images on an external monitor so your doctor can look inside the colon. An examination with flexible sigmoidoscopy takes about 15 minutes. If harvested tissue for biopsy may take longer.

After the examination

After sigmoidoscopy the patient may felt a slight discomfort, feeling bloated or flatulence manifest several hours until the air is removed from the colon. Walking can relieve any discomfort. After the procedure, the patient can immediately return to his normal diet and activities.

In addition to that, the patient may notice a small amount of blood present after the first stool after investigation. This is not a cause for alarm. Consult your doctor if you notice the presence of blood or blood clots during elimination seat, if you have persistent abdominal pain, fever higher than 38 C.

Side effects and complications

Side effects are unwanted effects that may be present temporarily after the procedure. Following the flexible sigmoidoscopy some mild pain and discomfort may occur. The abdomen may be inflated because the air was pumped into the intestine. The situation will improve after about an hour.

Complications relate to problems that might occur during or after the procedure. Possible complications may include:

- damage or cracking intestine – although it may occur rarely during the procedure, the situation could be present when the doctor remove a polyp or tissue for biopsy harvest and could result in infection. If high temperature, severe pain or swollen abdomen occurs, seek medical advice immediately. - bleeding – this is possible if polyps were removed or if you have taken a tissue sample for biopsy. In this case, the bleeding will stop within a few days by themselves. If bleeding is profuse or if you detect blood in your stool, consult doctor immediately. - sedatives

Results

The doctor will evaluate flexible sigmoidoscopy results and then he will share them to his patient.

- Negative – it refers to the case when the doctor does not detect any abnormality in the colon. If you have a medium risk of developing colon cancer, your doctor may recommend that you wait five years and repeat the exam. - Positive – is present if the doctor finds polyps or the presence of abnormal tissue in the colon. Depending on results, additional tests may be needed such as colonoscopy, so that any possible defects to be analyzed thoroughly, tissue biopsy will be collected and will be analyzed carefully.